never_land 发表于 2011-8-15 09:43
$ R9 X8 h p9 W: x) L8月12日开始易瑞沙。富露施也吃回来了。
7 H3 X Q+ `$ t5 A5 f回来看看你。希望一切都好，你也要注意自己的身体。
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. x8 a2 B' k5 m7 w: Q9 {你老公以前吃易瑞沙多久？管用么？这里有两个调查性质的study，是关于重新吃易和吃特的，虽然只是调研性质的不是系统性的研究，而且没说再次服用能管用多久，但是是挺positive的结论。不管是易还是特，思路都是针对EGFR TKI的。$ e! ~5 ^' v @0 d
# R p. G8 y& s6 S3 y; {只是去年初的，关于易的，原文已经不再网上了。* L8 K& Q4 V3 B$ K) Z6 F3 f t
There is an interesting article from Elsevier Global Medical News about a small phase II trial in which 18 patients who had previously responded well to Iressa (Gefitinib) returned to it after subsequent chemo failed.! i) X& S5 i" a7 G6 B7 {7 `" M
# A- V2 @8 D* M& ^& m+ ^The median initial treatment with Iressa was 264 days, with 39% partial response and the remaining 61% achieving stability. Upon retreatment, 27% had a partial response and 53% had stable disease. The median length of retreatment was 86 days. All 3 patients with known EGFR mutations responded, as did 10 of 12 who were female non-smokers.2 |4 m- Z8 i7 x$ T6 s8 ]
1 j4 ~4 J) F7 DGranted it's a very small trial (which the investigators intend to fully populate this year) and it's Iressa not Tarceva, but it certainly seems that EGFR TKI retreatment could be an option when other proven treatments have been exhausted. ^9 q- u0 L1 P3 J* v% N2 n/ P
; p; i1 B! r! y0 F; s* o/ i7 I6 `这是关于特的，今年六月份的，要注册才能读abstract和全文，这是abstract. 全文挺长的，我download了PDF，如果你要，可以给你。2 r6 L$ i6 z1 q0 Q7 W
Background
" U3 G: U2 Q% P; ~; Y+ QTyrosine kinase inhibitors (TKI) of the epidermal growth factor receptor (EGFR) are approved as treatment of non-small-cell lung cancer (NSCLC). Despite an initially impressive response to EGFR-TKIs, patients with an activating EGFR mutation invariably relapse. For these patients few treatment options are available after additional progression during or after chemotherapy. The aim of this study is to examine the effect of retreatment with an EGFR-TKI after a drug holiday./ m* D& t& f$ @' X$ ? g
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We retrospectively reviewed the medical records of 14 patients with stage IV NSCLC who progressed after long-term disease control with EGFR-TKI, who were subsequently treated with standard chemotherapy and at renewed progression retreated with EGFR-TKI.
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$ {2 h+ u$ U8 |; b+ V: Q: {Results5 z. O& f- t3 ]6 x# {% J' F2 r
Fourteen patients (five male, nine female, median age 55years (39–70years) received retreatment with erlotinib. The median interval from the discontinuation of EGFR-TKI to the 2nd episode was 9.5months (3–36months). Before starting retreatment 36% (n=5) had a T790M mutation. Retreatment resulted in 36% (n=5) partial response, 50% stable disease (n=7) and 14% progressive disease (n=2). Among patients with a T790M mutation this number was two, one and two, respectively. Seven patients are still on therapy without signs of progression. Median follow up is 9months (1.5–16+months) and median PFS is 6.5months (1–16+months).: i+ F3 c$ [/ `5 J5 Y! b
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Our findings suggest that retreatment with erlotinib is an option for patients with NSCLC who initially benefited from previous EGFR-TKI treatment and progressed after standard cytotoxic chemotherapy. |
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